# GARY L ZOUTENDAM DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639440233
- **Authorized official:** GARY L ZOUTENDAM (OWNER)
- **Authorized official phone:** (269) 962-8505

## Contact information

- **Practice address:** 491 E. COLUMBIA AVE, SUITE 3, BATTLE CREEK, MI 49014-5468
- **Practice address phone:** (269) 962-8505
- **Practice address fax:** (269) 962-9160
- **Mailing address:** 491 E. COLUMBIA AVE, SUITE 3, BATTLE CREEK, MI 49014-5468
- **Mailing address phone:** (269) 962-8505
- **Mailing address fax:** (269) 962-9160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901016510 | MI | Yes |

## Other

- **Enumeration date:** 01/13/2012
- **Last updated:** 01/17/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2990454 | — | MI |